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Impact of Cerebral Microbleeds on Gait, Balance, and Upper Extremities Function in Cerebral Small Vessel Disease
Yutong Hou1, Shuna Yang1, Yue Li1
1Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, 100020 Beijing, China.
Background And Purpose:
White matter hyperintensites (WMHs) , lacunes and brain atrophy have been demonstrated to be positively related to gait disorder. However, cerebral microbleeds (CMBs) as a manifestation of cerebral small vessel disease (CSVD) is still under-investigated. Therefore, correlations between CMBs and upper extremity, gait and balance performance were investigated in this study.
Methods:
A cross-sectional study of middle-aged to older adults was conducted. CSVD burden was measured with magnetic resonance imaging (MRI) and the location and number of CMBs were analysed. Gait and balance functions were evaluated using a four meter walkway, Tinetti, Timed-Up-and-Go (TUG) and Short Physical Performance Battery (SPPB) tests. Upper extremity function was measured by 10 repeated pronation-supination time, 10 repeated finger tapping time, and 10 repeated opening and closings of the hands.
Results:
A total of 224 participants were included in this study, with a mean age of 60.6 ± 10.5 years. The prevalence of CMB was 34.8% and most was lobar. Multiple linear regression analysis showed that CMB was associated with lower gait velocity, wider stride width, longer TUG test time, and poor performance on Tinetti and SPPB tests independently of other coexisting CSVD markers and risk factors. These relationships appeared to be explained by CMBs in the frontal, temporal, basal ganglia and infratentorial regions. The motor function of upper extremity also had independent correlations with CMBs especially in frontal, parietal, and temporal areas, and in the basal ganglia.
Conclusions:
CMBs were found to be associated with both gait, balance and upper extremity disturbances. The presence of CMB seems to be another major driving force for CSVD on lower and upper extremity impairment in healthy elderly subjects.
Insights
Cerebral microbleeds (CMBs) are linked to impaired gait, balance, and upper limb function in older adults. This study highlights CMBs as a significant factor in mobility and motor deficits associated with cerebral small vessel disease (CSVD).
Area of Science:
- Neurology
- Geriatrics
- Radiology
Background:
- Cerebral small vessel disease (CSVD) encompasses conditions like white matter hyperintensities, lacunes, and atrophy, known to affect gait.
- Cerebral microbleeds (CMBs), another marker of CSVD, have been less studied regarding their impact on motor function.
- Investigating CMBs is crucial for understanding the full spectrum of CSVD-related neurological deficits.
Purpose of the Study:
- To explore the association between cerebral microbleeds (CMBs) and motor performance in middle-aged to older adults.
- To determine if CMBs correlate with gait, balance, and upper extremity function.
- To assess the independent contribution of CMBs to motor impairments in the context of other CSVD markers.
Main Methods:
- A cross-sectional study involving 224 middle-aged to older adults.
- Cerebral microbleed (CMB) burden assessed via MRI, noting location and number.
- Gait, balance (e.g., TUG, SPPB, Tinetti), and upper extremity motor function (e.g., finger tapping, hand opening/closing) were evaluated.
Main Results:
- 34.8% of participants had CMBs, predominantly in lobar regions.
- CMBs were independently associated with reduced gait velocity, wider stride, longer TUG times, and poorer performance on balance tests (Tinetti, SPPB).
- Upper extremity motor function also showed independent correlations with CMBs, particularly in frontal, parietal, temporal, and basal ganglia regions.
Conclusions:
- Cerebral microbleeds (CMBs) are significantly associated with disturbances in gait, balance, and upper extremity function.
- CMBs represent a key factor contributing to lower and upper extremity impairments in elderly individuals with CSVD.
- These findings underscore the importance of considering CMBs in the evaluation of motor deficits in aging populations.
